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Sodium Thiosulfate

Class: Antifungals, Miscellaneous
ATC Class: D08AX07
VA Class: AD200
CAS Number: 10102-17-7
Brands: Versiclear

Introduction

Antifungal.b

Uses for Sodium Thiosulfate

Pityriasis (Tinea) Versicolor

Treatment of pityriasis (tinea) versicolor caused by Malassezia furfur (Pityrosporum ovale).a b

Sodium Thiosulfate Dosage and Administration

Administration

Topical Administration

Apply topically as a 25% lotion or solution (not commercially available in the US).a b Aqueous solutions of the drug are prepared extemporaneously.b Commercially available in the US in fixed combinations with salicylic acid 1%.a Do not apply to or near the eyes.a b

Thoroughly cleanse and dry affected areas before applying.a b

Shake lotion well.a

Apply a thin film to affected and other susceptible areas.a

Treatment is usually several weeks to months; however, evidence of active infection may disappear within a few days.a b

Dosage

Pediatric Patients

Pityriasis (Tinea) Versicolor
Topical

Children ≥12 years of age:c Apply twice daily.a b

Adults

Pityriasis (Tinea) Versicolor
Topical

Apply twice daily.a b

Cautions for Sodium Thiosulfate

Warnings/Precautions

Sensitivity Reactions

Possible irritation or sensitivity; if occurs, discontinue therapy.a b

General Precautions

Use of Fixed Combinations

When used in fixed combination with salicylic acid, consider the cautions, precautions, and contraindications associated with salicylic acid.a

Specific Populations

Pregnancy

Category C.d

Pediatric Use

Manufacturer states safety and efficacy not established in children <12 years of age.c

Sodium Thiosulfate Pharmacokinetics

Elimination

Elimination Route

Systemically absorbed drug is excreted in urine (29% as unchanged drug).e

Half-life

Systemically absorbed drug: 80 minutes.e

Stability

Storage

Topical

Lotion

15-30°C.a

Actions and Spectrum

  • Active against Malassezia furfur (Pityrosporum ovale).a

Advice to Patients

  • Importance of applying to affected areas as directed and avoiding contact with eyes.a b

  • Importance of informing patient that evidence of active infection may disappear within a few days, however, treatment is usually several weeks to months.b Importance of completing full course of therapy, even if symptoms improve.b

  • Advise patients to discontinue use and consult clinician if treated area becomes irritated.b

  • Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.a

  • Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs.a

  • Importance of informing patients of other important precautionary information. (See Cautions.)

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Sodium Thiosulfate

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Bulk

Crystals*

Sodium Thiosulfate Combinations

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Topical

Lotion

25% with Salicylic Acid 1%

Versiclear Lotion (with isopropyl alcohol 10% and propylene glycol)

Hope

AHFS DI Essentials. © Copyright, 2004-2014, Selected Revisions May 1, 2008. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

References

a. Hope Pharmaceuticals. Versiclear lotion (sodium thiosulfate 25%) prescribing information. Scottsdale, AZ; 2000 Apr.

b. AHFS Drug Information 2007. McEvoy GK, ed. Sodium thiosulfate. Bethesda, MD: American Society of Health-System Pharmacists; 2007. From website: .

c. Sherman, MD (Medical Director, Hope Pharmaceuticals, Scottsdale, AZ). Personal communication; 2007 June.

d. American Regent, Inc. Sodium thiosulfate injection, USP prescribing information. Shirley, NY; 2003 Jan.

e. Shea M, Koziol JA, Howell SB. Kinetics of sodium thiosulfate, a cisplatin neutralizer. Clin Pharmacol Ther. 1984; 35:419-25. [IDIS 183713] [PubMed 6538126]

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